Rating, A+++, all the way!!! I was referred to Dr. Paine by a personal friend who has been in the medical industry on and off for many years. My friend assured me that I would be in excellent hands and that my care would be the upmost priority, as it most certainly was! Dr. Paine and her staff are very caring, attentive and available, night or day, to answer any questions and/or concerns that I may have about my procedure. Dr. Paine and her outstanding staff made me feel as if I was their only priority. There is no other doctor, or staff, that I would rather have gone to. Top notch, and first class service!As an incentive for posting a review, this reviewer received an entry into RealSelf’s monthly $500 gift card giveaway.
You should see a board certified plastic surgeon to perform a physical exam, so the treatment can accurately reflex what the deficiency is. Indentations can be caused by several different things but generally there is either a not enough soft tissue (i.e. often fat) or not enough skin. This is a difficult issue to treat and you would want to see someone who focuses on body contouring. Ideally treatment would need to consist with replacing some of what was taken with the previous surgery. I would first discuss this with the surgeon who performed the initial surgery. You can to see what they would do to revise the area. I would also suggest getting the opinion of a few other plastic surgeons. You will likely find several different approaches to treating the issue. Ask lots of questions and find someone that makes you feel comfortable and you can have a good relationship with.
Seeing a board certified/eligible plastic surgeon would let them do a physical exam to confirm that a rectus diastasis is what is causing your concern. That being said it is very common for people after childbirth to notice that their stomach no longer retains a flat shape even if they are maintaining a healthy lifestyle and working out. This is because pregnancy can stretch out the tissues that hold your rectus abdominis muscles together. When this happens you can continue to make those muscles stronger but no exercise with bring them back together, they need to be surgically brought back together. This is what is called a rectus diastasis and correcting this along with excess skin is one of the biggest benefits of doing a abdominoplasty.
If you are not interested in changing you breast size and only want a more lifted look, then a breast lift without implants is very reasonable to consider. A board certified/eligible plastic surgeon would be able to discuss with you in detail your goals and also what you could expect for your results. A lift will often move the nipple position more centrally on the breast mound and also tightens the skin around the breast tissue. While it does not make a significant difference in the upper part of the breasts, it does tend to give the breast a nicer more projected shape. If you want a mild improvement in the upper part of the breast you could also consider doing a small amount of fat transfer to that part of the breast, which is good for contour improvements, but would not significantly change the size of your chest. Obviously everything comes with it's own risks and benefits and you would want to have a detailed discussion with your preferred surgeon about what works well in their hands and the type of results to expect.
Patient's operative results can change radically over the first 3-6 months and can continue to change up to the first year after surgery (sometimes there can continue to be some changes after the first year, but generally 1 year is when things should be pretty steady). In any breast procedure whether it is a reduction, lift, augmentation, or lift with augmentation the breasts will start high on the chest and then slowly drift down to a more natural state over the first 3-6 months. This is due to the swelling going away and natural relaxation of the tissues. The amount that the tissue descends is related to the weight of tissue remaining and your natural breast shape. There are a few things a surgeon can do to "encourage" the tissues to remain higher, such as using meshes, but this can add expense, additional risk, and cannot guarantee that everything will remain as lifted. I would get several opinions form board certified/eligible plastic surgeons and especially ask questions about how the surgeon would expect things to settle overtime. In addition, gravity continues to work on breasts even after surgery, so the more tissue you have (i.e. the larger the implant), you may see additional descent of tissues over the years since there is more weight on them.
It is possible to do a revision breast surgery after a breast reduction to removal additional tissue. After a breast reduction the breast can still change with time, changes in weight, and pregnancy. You would need to see a board eligible/certified plastic surgery to do an exam and determine why these symptoms have returned. After a breast reduction the tissues alway do relax somewhat and don't maintain as high as a position as the original reduction, so a plastic surgeon could help discuss whether this is return of breast tissue or relaxation of the tissues.
